Jean L. Kristeller, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040676A Issued in IN

Practice address

4435 Lancashire CT
Terre Haute, IN 47803-2092

Phone

(812) 877-3760

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Yale University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jean L Kristeller PH D

  • Clinical Psychologist
  • Terre Haute, IN
  • NPI 1023762176
  NPD Authorized official
• Indiana State University

  • Physical Therapist
  • Terre Haute, IN
  • NPI 1063612257
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1629143284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PSYCHOLOGY DEPARTMENT",
            "address_2": "INDIANA STATE UNIVERSITY",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478090001",
            "telephone_number": "812-237-2467",
            "fax_number": "812-237-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 LANCASHIRE CT",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478032092",
            "telephone_number": "812-877-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTELLER",
        "first_name": "JEAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040676A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200280980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Azumi Koyama
• Brittany Krassenstein
• Austin Krause, LAT, ATC
• Morgan Kremer, PA-C
• Keaton Krischak
• Kroger Limited Partnership I
• Kroger Limited Partnership I
• Kroger Limited Partnership I
• John Kuchinskas, LCSW
• Amber Nicole Kuhn, L M.S. LMNCA

• Clinical Psychologist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.